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HEAD - INSURANCE DEPARTMENT

Confidential Company

Posted on July 6, 2018

5 - 10 years Sharjah - United Arab Emirates

Other(Other). Any Nationality Male

Opening 01

Job Description

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JOB SUMMARY

Managing and supervising the overall function of OP & IP insurance approvals. Reporting directly to Head of Revenue Cycle.


DUTIES AND RESPONSIBILITIES

Main Duties
• Acquire good knowledge of agreed terms, protocols and procedures mutually agreed with insurance companies/TPAs.
• Supervise the team and oversees overall functionality of OP & IP insurance department segments.
• Keep a good and healthy liaison with Insurance Companies/TPAs for tackling submission, resubmission issues and replying queries raised by Insurance Companies/TPAs efficiently.
• Coordinate with clinicians and/or other clinical staff of different specialities for gathering relevant information/documentation for onward submission.
• Oversee the provision of an efficient and timely submission of the requested services/procedures by the clinics and providing necessary guidelines in case of conflict.
• Able to prepare cost estimation and negotiate/discuss with Insurance Companies/TPAs regarding disparities of internal-CPT Codes and/or of prices-selected codes with insurance companies.
• To generate periodic reports pertaining to different stages of insurance process loop and/or as per the KPIs.
• Act as liaison between IT, support services and other concerned department.
• Collect and analyse information from HIS to respond to delays, complaints raised by patients and implement remedial action.
• Ensure and maintaining Patient’s Medical Records confidentiality at all times and if any of the concerned staff disclosing confidential/patient records or information to any unauthorized person or persons; reporting to Head of Revenue e Cycle.

Team management
• Provide induction training to new staff and develop the knowledge and skills of existing staff.
• Ensure all staff in the team conducts themselves in a professional manner, are well presented and responsible for their discipline in accordance with Company policy.
• Provide training and support to staff regarding revision in insurance policies in coordination with RCM.
• Review the performance and competence of staff through annual appraisal, identifying training needs and arranging for its provision in conjunction with Head of Revenue Cycle.
• Manage daily Duty-Rota and annual leaves to ensure that staffing levels remain appropriate throughout the year.


Qualification Bachelor’s degree
Experience- Minimum 5 years - 10 YEARS experience in healthcare sector.

How to apply
Send your cv to hrsdxb1@gmail.com


Insurance / Underwriting / Surveying / Actuary

Keywords

Insurance Operations

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